J Korean Soc Ther Radiol Oncol.  2010 Sep;28(3):117-124. 10.3857/jkstro.2010.28.3.117.

Treatment Outcome and Analysis of the Prognostic Factors of High Grade Glioma Treated by Postoperative Radiotherapy

Affiliations
  • 1Department of Radiation Oncology, Korea University College of Medicine, Seoul, Korea. kcyro@korea.ac.kr
  • 2Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To analyze the postoperative radiotherapy results and prognostic factors in patients with WHO grade 3 and 4 gliomas.
MATERIALS AND METHODS
A total of 99 patients with malignant gliomas who underwent postoperative radiotherapy between 1988 and 2007 were enrolled in this study. Total resections, subtotal resections (> or =50%), partial resections (<50%), and biopsies were performed in 16, 38, 22, and 23 patients, respectively. In total there were 32, 63 and 4 WHO grade 3, 4, and unspecified high grade gliomas, respectively. The biologically equivalent dose was in the range of 18.6 to 83.3 Gy(10) (median dose, 72.2 Gy(10)). We retrospectively analyzed survival rate, patterns of failure, prognostic factors, and adverse effects.
RESULTS
The median follow-up time was 11 months and there were 54 patients (54.5%) with local failure. The one and 2-year survival rates were 56.6% and 29.3%, respectively, and the median survival duration was 13 months. The one and 2-year progression-free survival rates (PFS) were 31.3% and 18.2%, respectively, and the median PFS was 7 months. The prognostic factors for overall survival were age (p=0.0001), surgical extents (subtotal resection, p=0.023; partial resection, p=0.009; biopsy only, p=0.002), and enhancement of tumor in postoperative imaging study (p=0.049). The factors affecting PFS were age (p=0.036), tumor enhancement of the postoperative imaging study (p=0.006). There were 3 patients with grade 3 and 4 side effects during and after radiotherapy.
CONCLUSION
In addition to age and surgical extents, tumor enhancement of the postoperative imaging study was included in the prognostic factors. The most common relapse patterns were local failures and hence, additional studies are needed to improve local control rates.

Keyword

High grade glioma; Prognostic factor; Radiation therapy

MeSH Terms

Biopsy
Disease-Free Survival
Follow-Up Studies
Glioma
Humans
Recurrence
Retrospective Studies
Survival Rate
Treatment Outcome
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